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The situation in hospitals throughout Gaza is "completely out of control", a health official said early on Wednesday after a missile strike on an overcrowded hospital killed hundreds of people and injured many more.
More than 3,000 people in Gaza have been killed and at least 12,500 injured since Israel began bombing the strip on October 7.
Hospitals are struggling to cope with the influx of wounded and displaced people looking for shelter.
Supplies of medicine, fuel and even water are running dangerously low under the "total siege" imposed by Israeli forces.
"The situation is completely out of control in all hospitals in the strip," said Mohammed Abu Salimah, director of Al Shifa Hospital in the Gaza Strip.
"We are conducting operations without general anaesthesia."
The situation is awful, said Nagham Mohanna, The National's contributor in Gaza.
"People have set up tents around the hospital, there is rubbish everywhere, the smell is horrific," she said.
Authorities fear outbreaks of disease as corpses and litter pile up and thousands of people seek shelter there.
"Civilians have nowhere to go, there are no services working to clean up the streets and devastation of the strikes," Mohanna added.
Doctors denounce strike on Al Ahli Hospital as 'war crime'
The World Health Organisation had previously said health centres in northern Gaza were operating far beyond their capacity, with tens of thousands of displaced Palestinians sheltering inside.
The situation was exacerbated overnight when an Israeli missile struck Al Ahli Arab Hospital, known locally as Al Mamadani Hospital, in Gaza city.
The blast killed more than 500 people and injured many more. Israel has denied responsibility and said the blast was the result of a failed missile launch by the Palestinian Islamic Jihad militant group.
Doctors who are already struggling to cope has condemned the bombing as an act of cruelty.
“We are overwhelmed. We are struggling to help the victims,” said Dr Hussam Abu Safiya, who works at Kamal Adwan hospital in the north of Gaza.
“We can’t deal with the large number of deaths and injuries.
“Most victims are women and children who were sleeping in the hospital.
“We expect more hospitals to be bombed. There is no safe place in Gaza.”
Physicians at the hospital have refused to leave, saying it could put the hospital's patients - many of whom are children - at risk.
MedGlobal, a non-profit medical organisation that works in Gaza, denounced the bombing of Al Ahli Hospital as a war crime.
“The bombing of the [Al Ahli] Baptist hospital is the worst attack on a medical facility in the 21st century,” said Zaher Sahloul, a critical care specialist and president of MedGlobal, which sends volunteer medical teams to support hospitals and clinics in Gaza.
“Its cruelty and the death toll of innocent patients, civilians and the healthcare workers trying to save them is staggering.
“Bombing hospitals is against international law. It is a war crime.”
Dr Sahloul said the bombing undermined medical neutrality and the 150-year-old Geneva Convention that specifies under no circumstances can hospitals, medical units and mobile medical units be attacked.
“It compounds trauma in the Gaza Strip, sending the message that nowhere is safe, not even inside a hospital,” he said.
Some of the wounded were being taken from Al Ahli Arab to Al Shifa Hospital, the largest in Gaza, adding to pressure on the healthcare system.
Israel ordered an evacuation of the northern half of the Gaza Strip, where 22 hospitals cater to 1.1 million people in Gaza City and its surrounding areas, ahead of an expected ground invasion.
The WHO said such an evacuation was impossible because of the numbers of people involved and warned it could be especially dangerous for injured patients.
"Forcing more than 2,000 patients to relocate to southern Gaza, where health facilities are already running at maximum capacity and unable to absorb a dramatic rise in the number of patients, could be tantamount to a death sentence," it said.
